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HomeMy WebLinkAboutTR-44-1-7 TRUST~e;S - :~ John M. Bredemeyer, III, President Albert J. Krupski, Jr., Vice President Henry R Smith John B. Tulhill Will,am G. Albertson Telephone (516) 765-1892 Fax (516) 7654823 BOARD OF TOWN TRUSTEES TO%rv~ OF SOU~rHOLD SUPERVISOR SCOTT L. HARRIS Town HaH 53095 Ma'm Road RO. Box 1179 Somhold. New York 11971 Permit Number: 44-1-7 Name of ADplioant/Agent: Costetlo ~arine Name of Permittee: Rosina Cunningham Address of Permittee: 55105 Rt 48, Southo!d PropertyLocated: SCTM ~1000-44-t-7 DESCRIPTION OF ACTIVITY: refill hole that was eroded by October ~1. storm with san~ and topsoil, then replanted with b~ach grass n lo~er half and Rosa Rugosa and grass on upper mid secti~n~ Rebuild stairs and attach to piatform~ SPECIAL CONDITIC~S: Bluff restoration through a re-vegetation agreement is at--~ched hereto and is a necessar?~- special condition of this permit. A relocation agreement is attached hereto am~ is a neeessary special condition of this permit. jFucx~, A maintenance agreement is attached hereto and is a necessary special condition of this permit. You MUST submit a licensed Land Survey oz the completed structure(s) for your maintenance agreement to be validated. Approved on September 17, 1992 by resolution of the Board Trustees. John M. Bredemeyer~ III President~ Board of Trustees TRUSTEES - :;% John M, Brc-~eyer~ Itt, Pres~dem i' Albert J. Kmpalti, Jn, ~e ~esident le~ ~. Tuthiil · elep~e G~) ~65-1892 Fax (51~) 765-1823 BOARD OF TOWN TRUSTEES TO%¥~ OF SOUTHOLD SL~ERVISOR SCOTT L. HARRIS Town I42.11 53095 Ma~ EO. Box 1179 Somhold= New NEGATIVE DECL~i~ATI ON NOTICE OF NO SIGNIFICAI~ EFFECT ON APPLICATION NO. 1000-44-1-7 Chapt~ NA~E: Rosina Cunninghsi~ Chapt. DATE: September 17~ 1992 97 - w¢~!ands 37 C0~s~al'Erosion RESOLVED that pursuant to Article 8 of the Enviroo~n~al Conservation Law~ Sta~e Environmental Quality Review and 6~fCRR~6!7~ Section ~17.10 and Chapter 44 of the Code of the T~n Of Southold~ notice is hereby given that the SoutholdTown Trus~e~aS Lead Agency for the action described belo%¢~ has. deter~n~d ~hat the project will not ~%ve a significant effect on the ~ir0~ent. Please take further notice that this declaration shoul~ ~ot be considered a determination made for any other depa~t Or ~gency which may also have an application pending for the'~ Or similar pro3ect. A planting survey shall be submitted prior to final approval, if applicable. ~fPE OF ACTION: Unlisted DESCRIPTION OF ACTION: request to refill hole that was eroded ~y October 91 storm with sand and topsoil, then reptant~= with beach grass on lower half and Rosa Rugosa and grass on upper mid sect±on. LOCATION:SC~( ~1000-44-1-7 REASONS SUPPORTING ~HIS 1. Ah on site inspection has been condL[cted by the Board of Trustees o 2. An envzror~ental assessment~ submitted by the applicant and reviewed and completed by the Board of Trustees, has indicated that no significant adverse effects to the environment are likely to occttr should the project be implemented as planned° TRUSTEES John M. B~em~yet, III, President Henry P Smdh, Vice Pres~ ent Albert J: KruPS]d, Jr. John L. Bednosld, It. - ~6hn B]:T~II Telephone (5,16) 765-i'S92 I~ax (5t~} 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 11'19 Soufllold, New y~rk 111971 COASTAL EROSION MANAGEMENT PERMIT.APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PERMIT APPLICATION Office Use Only: /Coastal Erosion Permit Application ~etiand Permih Applicati°n ~ TrusteeLands Permit Appiicatlon ~_Grandfather __Completed Apps. Date: ~__%Variance Requireg, Neighbors notified Date: -- SEQRA Type Coerd. Review-opt.,mand. comp./date: /date: tg/date: Date Rec. by Office (Y/N): Special Conditions: (al~0 see file) Application Fee: Applxcatzon Number;.SCTM ~i000- ~ - I- 7 Project-Name- (If any} _ ~OSIN~ ~3. Date Prepared: Applican%: ~oST~ kk~ ~a~ ~E /Phone Interest: (owner, consultant, lessee,etc.) Address ~/0.~ ROUTE ~ ' ' Phone Subject Property Location: h~%%G (Provide LILCO Pole #, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Yds. to be excavated: O Yds. to be filled: Manner in which material wilt be removed or deposited: Width of c~nal, c~eek or ba~ fronting property:' ~ Depth at low tide: __~6_~ Aver. rise in tide: Distance to nearest channel: N~ Distance~pr°ject extends beyond similar projects i~ area: Area zoning: ~na~. Land area in acres:~ 9~5 ~,~· Is project for private or business use: Dn~ Intended use of property: J~,~-l-~0 Describe known prior operations conducted on premises: Has any prior license or permit been issued to erect structures, dredge, or deposit fill on said premises: klO Has any license or permit ever been revoked or suspended by a Governmental Agency: ~ Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., 'pipeline and septic system; make additional attachments if necessary)· Authorization {Where the applicant is not the owner) ~ I residing at (Print-owner of subject property) (Mailing address-phone) do hereby authorize to apply for Coastal Erosion permit(s) from the Southold Town Trustees Signature THIS IS NOT A PERMIT County of Suffolk ) State of New York ) AFFIRMS THaT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIt(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN'THIS APPLICATION ANDAS MAY BE APt !~VED BY THE SOUTHOLD TOWN BOARD O~ TRUSTEES. THE APPLICANT AG[ EESS AND~EFRoMANY AND ALL DAMAGES AND CLAIMS ARISING ~ :EsTO~HOLD THE TqWN OF S0UTHOLD AND THE TOWN TRUsTEES ia oR By ¥I~TUE OF SAiDPERMiT(S), IF GRANTED. IN ~OFIPLETIN~ THIS APPLICATION; IHEREBY AUTHORIZE THE TRUSTEES, THE ~AGENT(s) OR REpRESENTATiVE(S), TO ENTE~ ONTO MY PROPERTY TO iNsPECT THE PREMISES IN CONJUNCTION WITH REVIEWOF THIS APP jICATION. SWORN TO BEFORE ME ~I GNATURE NOTARY PUBLIC' 0 Suggested space for location Map ~{IS IS NOT A PERMIT lz/// /: TOWN OF SOUTHOLD EAF ENVIRO;IMENTAL ASSESSMENT PART Project Info~m~tion ~OTICE: This document (~ 5es~ened 'to assist tn determining whether the action proPosed may have a ~ificant effect on the e~v)~cnment. Please complete the entire Data Sheet. Answers to these ouestions will b considered as Dart of the ~bliaation for aoeroval and may be subject to further verfftoation anu pub)ia review, Provide any additional ~n~onn~Lion you believe will be neeoea to comblete PARTS 2 and 3. It is exoecteo that ccmo)~tlon of the EAF will be denendent on infomation currently available and will not involve new studies, r~search or tnvesctqation. If information renuirino sucn additional wor~ is Joava~b)e, so lndfcate and soe'cify each instance. ~(AME OF PROJECT: -RB,~iI,,)A -J:J, d. UUI~i'~C~AtA ADDmESS AND N~E OF APPLICANT: thane) (SCree~) (P.O.) ~-. (Sca.e) | NAME AND ADDRESS OF OWNER (If ~ifferent) (Name) (StreetJ BUSINESS PHO~: OESCRIPTID~ OF PROJECT: (Briefly describe type of ~roJect or action) (PLEASE COMPLETE EACH QUESTION - Indicate N.A, if not applicable) A. SITE DESCRIPTION (Physical setting of overall project, both develoned and undeve]o~ed areas] - 1' Genera) character of the )and: r, eneralty uniform slooe ~Generally uneven and rollino or irreou]ar 2. Present )and use: ,Agricu]ture 3. Total acreage of oroject area: ,..~ acres, Urban , Industrial.. ,Commercia] , Suburban ., Rural ., Forest , Other ~i~'~.~.L.l~k)-I'/ p,L~ Aooroximate acreage: Presently After Cemnletion Presently After Completion Meadow or Brushland -- acres ~ acres I'{ater Surface Area ~ acres _~'~__ac-es Forested -- acres -- acres Unvegetated (rock, earth or fill) ~ acres -- acres Aoricul rural -- _acres acres Roads, buildinns la, ~15 or F.C.L.~ _----acres -- acres Other (indicate ty~e) acres acres g i..S ~.at ~ de~t~ tc bedrock? ....... ~J_/~lr ........ (~n ~eet) 6. A~oroxir~ate percentage of proOosed oroject site with slopes: 0-10~ /S; 1A-I~ .:~; 15~ or greater l:. 7. Is project contiguous ,t~Or contain a buildinn or site listed on th'e National Register of Historic Places? . Yes / NO ' B. What is the depth to the water table? JL/tA feet g. Do hunting or fishing opportunities presently exist in the project areal No 10. Does project site contain any species of plant or animal life that is identified as threatened or endane, er,ed - .. .Yes :~0. according to - Identify each species A,/O 11. Are there any unique or unuF~u~al land forms on the project site? (i,e. cliffs, dunes, other geological formations - . Yes v~ No. {Describe 12. ~s the project site p~sently used by the con~nity or neighborhood as an eden soace or recreation area - Yes 13. ODes the ~resep~te offer or include scenic views or vistas known to be imoortant to the community? Yes l/,~ No 14. Streams within or contiguous to project area: / a. Name of stream and name of river to which it is tributary 1S. 16. B. Lakes, Ponds, Wetland areas within or contiguous to oroject area: a. Nar~e .. /~ ~ ~0~ ~,k ~ : b. Size (in acres) What is the dominant land use and zoning classification within a 1/4 mile radius of the project {e.g. single family residentia), R-g) anU t~e scale of develooment (e.g. 2 story). PROJECT DESCRIPTION I. Physical dimensions and scale of project {fill in dimensions as appropriate) a. Total contiguous acreage Owned by project sponsor *.~"- acres b. Project acreage develooed: ~/Y~ acres initially; acres ultimately. c, Project acreage to remain undeve)ooed AJ/~ · ! d. Length of project, in miles: /~/~ (if appropriate) e, If project is an exoansion of existing, indicate oercent of exoansion proposed: age ; developed acreage ~. Number of off-stre~.t parking sea{es existing LJ/~) ; proposed building square foot- g. ~aximum vehicular trios generated 3er Dour h. If residential: Number and type of housinq units: 9ne Family Two Family Initial Ultimate t. If: Orientation .:)ei§hborhood-City-Regiona! Co,Inet{ia) Industrial - { A)/./~' (upon completion of oroject) Multiple Family Condominium Estimated Employment 2. How much natural materia) (i.e. rock, earth, etc.) will be removed from the site - ~) tons ~r~ cubic yaros. 3. How many acres of veqetation (trees. shrubs, ground covers) ~ill be remov~ from site - ~) acres· 4. Will any mature forest {j~r 100 years Old} or other locally-~mportant vepetation oe project? Yes .~ No . . ' ' S. Are there any ~lans for re-vegetation to reolace that re~ved during c:~..r: rio 6. If single ~nase project: Anticipated period of construction J months, (i~luding demolition). 7. ) f multi-phased DKOj~Ct~ a. Total n~beK of ~hases an?ici ~ated r de~lition) c. A~roximate comoletion date final Dbase ~nth d. Is phase 1 financially ~pend~nt on subseauent ohases? Yes . No 8. Will blasting' occur du~ing construction? Yes 9. N~ber of jobs generated: during construction ,~ ~ after project ts.complete ~ . 10. Nu~er of jobs eliminated ~y this ~roj~ct ~.. 11. ~tll p~ject reauire relocation of ~ny projects or ~citities? __Yes / No. If yes, explain: 12. a. Is surface or subsurface liouid waste disposal invulved? . .Yes ./..No.' b. If yes, indicate type of waste (sewage, industrial, etc.) ¢. If surface disposal name of stream into which effluent will be discharged 13. Will surface area of existing lakes, ponas, streams, bays or other surface waterways be increased or decreased by proposal? "es No. 14. Is project or any portion of project located in the lO0 year flood plain? ~es No 15. a. Does project involve disposal of solid waste? Yes v~No b. If yes, will an existing solid waste disposal facility be used? Yes No c. If yes, give name: /V/~ : location d. dill any wastes not go into a sewage disposal system or into a sanitary landfill? __Yes 16. Will ~rbject use herbicides or pesticides? __Yes v~No 17. Will project routinely produce bOOrS (more than one hour Der day}? Yes 18. Will project produce operating qoige exceeding the local ambience ~.ise levels? Yes 19. Will project result ~n an increase in energy use? __Yes /No. If yes, indicate type(s) J No 20. If water suPPly is from wells indicate DumPing capacity 21. Tota) anticipated water usage Der day _~ .gals/d~.v. 22. loping: a. What is dominant zbnlng classification of site? gals/m~nute. If no, indicate oesired m 26. Appr'ovels: IS any Federal permit reauired? Yes v/x NO Does project involve State or Federal funding or financing? Local and Regional approvals: Approval Reoui red (Yes, No) (Type) Yes _~ No Submittal Aonroval (Date) (Date) City, Town, Village Board City, Town, Village Planning Board City, Town Zoning Board City, County Health DePartment Other local agencies ..~_~_ Other regional agencies State Agencies ~.~S Federal Agencies C. IBFOPJ4ATIONAL DETAILS Attach any additional information as may oe needed to clarify your project. If there are or may be any adverse impacts associated with the proposal, please discuss such impacts and the measures which can be taken to mitiga:e or avoid them. r', PREPARER'S SIGNATURE: ~ g~L.~LAY,) ~ EAF ENVIRONMENTAL ASSESSMEN~ ~ PART II Project Impacts and Their Magnitude General Infnr'nmtion {R~ed Carefully) - In complecing toe form the raviewer should be guided by the ouestion: Have my decisions and determinations been reasonable? The reviewer is not expected to be an ex~ert environmental analyst. - Identifying that am effect will be potentially large {column 2) does not mean that it is also necessarily $1onificant. Ar~7 large effect must be evaluated in PART 3 to oetermine significance. By identifying an effect 'in column 2 simply asks that it be looked at further, - The Examples provided are to assist the reviewer byshowingtypes of effects and wherever possible the thres of magn}tuo~.that would trigger a response in column 2. The examples are generally applicable throughout th State and for most situations. But, for'any specific prdject er ~ite other examples a~d/or lowe~ thresholds may be more appropriate for a Potential Large Impact rating. - Each project, on each site, in each locality, will vary. Therefore, the examples have been offered as gu(dm They do not constitute an exhaustive list of impacts and thresholds to answer each ouestion. - The number of examples :er question does not indic~e~he importance of each ouestion. INSTRUCTIONS {Read ~arefully} a. Answer each of the 18 questions in PART 2. Answer Yes if therewill be any effect. b. Maybe answers should.be considered as Yes answers. If answering Yes to a ouestion then check the appropriate box {column 1 or ~) to indicate the potential size of the impact, If impact threshold equals or exceeds any example provided, check column 2. If impact will occur but threshold is lower than example, check column 1. d. If reviewer has doubt about the size of the impact ~ben consider the imDact as potentially large and oreceen to PART 3. e. If a ~otentially large impact or effect can be reduced by a change in the project to a less than large magnitude, place a Yes in column 3. IMPACI' ON LAND A Nc response indicates, that such a reduction is not possible. 1. ~. ~. WILL THERE BE AN EFFECT AS A RESULT OF A PHYSICAL CMANGE TO PROJECT SITE? Examoles that Would Amply to Column 2 Any construction on slopes of 15% or greater, (15 foot ri se per -- )DO foot of length}, pr where the general slopes in the project area exceed 10%. Construction on Land wnere the depth to the water table (S)ess than 3 feet. NO YCS ©0 SMALL TO POTENTIAL CAN IHPACT BE MODERATE LARGE REDUCED BY IMPACT !MPACT PROJECT CHANGE ~!!ALL TO POT~.~TIAL CAN I'IPACT BE - ~nBEI~TE LARGE REDUCED BY IMPACT IMPACT POOJECT CHANGE TO YES 2. WILL THERE BE AN EFFECT TO ANY UNIQUE OR U~)SUAL LAN~ FOUND ON THE SITE? {i.e. cltff~, dunes, oeoloqical fnrma- tio~s, etc.) - ' 5neciftp land forms: ~¢PACT ON ~ATER 3. WILL PROJECT AFFECT ANY ~ATER BODY DESIGNATED AS .......... PROTECTED~ (Under Articles 15, 24, ~5 of the Envtr- ~ Construction in ~ designated freshwater o~ tidal wetland. surface area. ~0 YES 5. UILL P~OJECT AFFECT SURFACE OR G~OU~D!4ATER ~UAL)TY? ~ Project will require a dischaKge pe~lt. th~n ~5 ~allonS oer minute pumo~ng capacity~ Construction or o~eration causing any contamination 6. :~ILL PR.QJECT ALTER DRAINAGE FLO~r, PATTE)!)IS OR SORFACE !lATER NO 1. 2.. YES RUNOFF? ................................................... O0 Examole that ~.~ould Anply to Colu~ 2 Proiect would imnede flood water Flows. project is likely to cause suostantial erosion. Project i~ (nco~atible with exis(ing drainage oatterns. Other tmoacts: ; 7. )~ILL PROJECT AFFECT AIR QUALITY? ......................... Fxample~. that l~ould Apoly to Colun~l 2 DO YE: "00 Project will induce ].OOO or n~re vehicle tri~)s in any given hour. Project will result in the incineration oF mor~ than I ton ef refuse per hour: Pro~ect emission rate oF al) contaminants w411 exceed S lb$. Der hour or a neat source nroducing more than 10 million BTU'S Der hour. IMPACT ON PLANTS AND ANIPALS 8. WILL PROJECT AFFECT ANY THREATENED OR ENDANGERED SPECIES? Examoles that Would Aooly to Colun~n Z Reduction of one or more species listed on the New York ~ or Federal list. using the site. over or near site or found on the site. Removal of any oortlon of a critical or sionificant wild- - life habiC.lC. Ao~licatinn of Pesticide or qe~icide over ~re than .NO YE! ©0 ;~IALL T(~ PnTENTIAL £AN IIiPACT BE ~lDEP~TE LARGE I REDUCE~ 0¥ ,4~AC. I~'PRCT PROJECT CH~(GE m ) ) g. !IILL PqojECT SUgSTA[1TIALLY AFFECT UON-THREATE~IED OR NO YES E'x~mole that Would Apply to Column 2 -7- 13. I'.'ll.L TT4E ~OJ~'CT .~rrECT VIEPS. VISTAS g9 T]I~ CHARACTER g~ TIlE ~I~IGNBQ~D aR CO",~IITY? .............. Examples that t~ould Apply to Column 2 An incommatible v(sua] affect caused by the introduction ~ of n~ materials, colors and/or fo~s in contrast to the ~ur~unolno landscape. .~ A oroject easily visible, not easily scr~eneo~that obviously different f~m nthers around it. ~ P~ject will result in the elimination or major screening of scenic views or vistas known to be tmoortant to the area. 11. IMPACT ON HISTORIC RESOURCES WILL PROJECT Ir~PACT ANY SITE OR STRUCTURE OF HISTORIC, NO PRE-I)IST~IC nR PALEOHTOG~CAL II~POPTANCE? ........... ~ Examples that Would Aooly to Column 2 P~oJect occurino wholly or martially within or contiguous to any facility or site listed on the Hational Reoister of historic glaces. Any imoact to an archeo]ogical site or fossil bed located within the oroject site. IMPACT ON OPEN SPACE & RECREATtO)~ 12, Other imeacts: WILL THE PROJECT AFFECT THE OUANTITY OR OUALITY OF EXISTIUG NO OR FUTURE OPEt~ SPACES OR RECREATIONAL OPPORTU!IITIES? ...... Exam~)es that ~lould A~lv :o Col um~ 2 A major reduction of an ooen space (moortant ~o the community. Other imoacts: NO )~CT nB TPANSPOPTATI~ 13. ?ILL THERE BE AN EFFECT TO EXISTIII¢ TRANSPORTATION SYSTEUS7 ............................................... Examples tna: Would Annlv to Column 2 1. 2.. 3. SMALL TA mQTENTIAL CA,~i I,'!PACT BE qODERATE LARGE REDUCED RY ["PACT I'~P~CT j P~QJECT CPqr(g) YES YES YES YES S~ALL TO POTENTIAL CAN IMPACT DE L'ODER~ TE LARGE, REDUCED BY MPACT I'tPACT PROJECT CHANGE Examples that Would Apply to Column 2 ~ Project causing qreater than 5% increase in any form of energy used in municipality. Project requiring thecreation or extension of an energy ~ transmission or supply sys%em to serve mOre than 50 sinqle or'two family residences. Other impacts: IMPACT ON NOTSE 15. WILL THERE BE OBJECTIONABLE ODORS, NOISE, GLARE, VIBP, ATION NO YE or ELECTRICAL DISTURBANCE AS A RESULT OF THIS PROJECT? .... E~amples that IJould Auuly to Column 2 Blasting within 1,SO0 feet of a hospital, school er other sensitive facility. Odors will occur routinely (more than one hour per day). Project will produce ooerating noise exceedinn the ~ local ambient noise levels for noise outside of structures. Project will rer~ove natural barriers that would act as a noise screen. Other impacts: ~MPACT ON HEALTH & HA~RD~ NO YF 16. 'JILL PROJECT AFFECT PUBLIC HEALTH AND SAFETY? ............. Examp.]es. that Nould Apply to COlumn 2 Project will cause a risk of exulosion or release of hazardous ~ substances (i.e. oil, pesticides, chemicals, radiation, etc.) in t~e even~ of accident or uosec conditions, or there will he a chronic lo~v )eve] discharge or emission, Project that will result in the burial of "hazardous wastes" (i.e. toxic, poisonous, highly reactive radioactive, irritating, infectious, etc., includino wastes that are solid, semi-solid, liquid or contai~ oases'.) Storaoe facilitiAs for one ~il]ion or more qallons of liouiried natural gas. or other liquids. Other imeacts: 17. IMPACT O I DROWTH AND CHARACTrR OF COMK~NITY OR !IEIfl~PuO~ WILL PROJECT AFFECT THE CHAPACTER nF THE EXISTING CO~IHUNI TY? ................................................ O0 Exemole that Would Apoly to Columo 2 The gouulation of the City, Town er Village in which the project is located Is likely to grow by more than ~% oF resident human ~opulation. ~A~£~O POTE;ITIAL £AN iHPACT 8E iOOERATE LARGE i REOUCEO BY I~PACT IIIPACT PROJECT CHANGE NO YES NO YES result of this project. Will involve any ~ermanent facility of a non-agricultural use in an agricultural district ar remove nri~e-agricultural lands from cultivation. The project will replace or eliminate existing facilities, Oevelooment will induce an influx of a particular age group with special needs. Project will set an imoortant precedent for future proiects. Project will relocate lS or more emoloyees in one or ~ore Other imoacts: 18. IS THERE PUBLIC CONTROVERSY CONCERNING THE PROJECT? ...... Examoles that Would Apply to Columo 2 Either §overn~nt or citizens of adjacent con. unities have exoressed o~osition or r~jected the prelect or nave no't been contacted. Objections to the oroject from within the CO~dnitY. IF ANY ACTION IN PART ~ IS IDE)~IFIED AS A i POTENTIAL LARGE IMPACT O~ IF YOU CANNOT DETEI~HIHE THE MAGNITUDE OF IHPACT. PROCEED TO PART 3. PORTIONS OF EAr COHPLETED FOR THIS PROJECT: DETE~HINATION PART I PA~T II PART 3,., Upon review of the information recorded on thts EAF (Parts l, 2 and 3) aha considerinq both the maonitude and Imoortance of each in'pact, it is reasonably determined that: A. The ~roject will result in no major imuacts and, therefore, B. Although the project could have a significant effect on the PREPARE A NEGATIVE DECLARATIOh -© PREPARE A NEA~TIVE ~ECLARATION © PR[PAR[ POSITIVE DECLARATIO~ PROCEED WITH --© in Lead Agenc~ EAF E)(VIROI4MERTAL ASSESSMENT - PART III EVALUATIO~I OF THE I~PORTANCE OF IMPACTS INFOR.~AT ION Part 3 is prepared if one er more imoaot or effect is considered to be ootenti~lly laroe. The amount of writino necessary to answer Oart 3 may be determined by answering the question: )n briefl~ completing the instructions below have I olaced in this record sufficient information to indicate ~e reasonab:leness of mv decisions? I~STRUCTIONS Complete the fol]owinq for each impact or effect identified in Column 2 oF Part 2: 1. BrieFly describe the imoact. 2. Describe (if apolicable) how the tmoact might be mitigated or reduced to a less than large imnact by a pro- Ject change. 3. Based on the information available· decide if it is reasonable to conclude that this innact is tmoortant to the mtnicioality (citE, town or village) in. ~hieh the uroject is located. To answer the ouestion of importance, consider: The probability of the imoact or effect occurring The duration of the impact or effect Its irreversibility, including permanently lost resources or values Whether the imoact er effect can ba controlled The regional conseouence of the impact or effect Its potential divergence from local needs and goals Whether known objections to the project apply to this imqact or effect. PAPT III STATEMENTS ~)ne {or more) imqact is determined to both larpe and its (their} cons~ouence, based on the review above, is important. {Continue on Attachments, as needed) TELEPItONE BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Fown Hall. 53095 Main Road P.O. Box 728 Southold, New York 11971 APPLICATION IS HEREBY MADE TO THE TOWN TRUSTEES, TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW' YORK, FOR THE ISSUANCE OF A PERMIT PURSUANT TO THE LAWS, ORDINANCES AND REGULATIONS GOVERNING THE COASTAL AND INTERIOR WETLANDS, FLOOD PLAINS AND DRAINAGE AREAS OF SOUTHOLD TOWN, AND THE ISSUANCE OF PERMITS PURSUANT TO CHAPTER 32 OF THE CODE OF THE TOWN OF SOUTHOLD. I APPLICANT' S NANE: -P, o~ ~ ~_. . ~__,,~;~ ~ m. _ t · [ ' LOCATION OF PROPER~ FOR REQUESTED PEmIT: HAMLET:-~__ O~t~ IA '--~ ~a..~. TAX ~4AP NO: ~ooo- ~q-/-? -~ CREEK, BAY OR HARBOR FRONTING PROPERTY: SIZE OF PROPOSED-WORK: WIDTH: ~/~ Page 2. YDS. TO BE EXCAVATED:_~/~ YDS. TO BE FILLED: MANNER IN WHICH MATERIAL WILL BE REMOVED OR DEPOSITED: WIDTH OF C~AL, CRE~ OR BAY FRO~ING PROPERTY: DIST~CE TO NEWEST CH~NEL: DIST~CE PROJECT EXT~DS BEYOND SIMIL~ PROJECTS IN ~EA: ~EA ZONING: ~ IS PROJECT FOR PRIVATE OR BUS. USE: INTENDED USE OF PROPERTY: ~+~ ~.*~;~0~ ~ ~ · DESCRIBE ~O~ PRIOR OPE~TIONS CONDUCTED ON PREMISES: HAS ANY PRIOR LICENSE OR PERMIT BEEN ISSUED TO ERECT STRUCTURES, DREDGE, OR DEPOSIT FILL ON SAID PREMISES: NO HAS ANY LICENSE OR PERMIT EVER BEEN REVOKED OR SUSPENDED BY .A GOVERNMENTAL AGENCY: Nb DESCRIBE FULLY THE REHABILITATION OF PROPERTY: DESCRIBE PROPOSED CONDITION OF PROPERTY AFTER WORK IS COMPLETED. INCLUDE AN ADDITIONAL SURVEY OF PROPERTY SITE IF NECESSARY: H0 C~D~ . ARE THERE ANY COVENANTS OR RESTRICTIONS IN YOUR DEED WHICH WOULD PROHIBIT THIS PROJECT: ~0 WRITTEN CONSENT OF OWNER IF NOT THE SAME AS APPLICANT: COUNTY OF SUFFOLK · STATE OF NEW YORK IN r' OF THIS BEING DULY SWORN DEPOSES DESCRIBED PERMITS THIS :,TOWN BOARD OF THE TOWN OF THE TOWN OF SOUTHOLD AND THE TOWN AND CLAIMS ARISING THEIR INSPECT THE PREMISES Signature3 of Applicant swo~ To EEFORE ME ~HIS /7 . NOTARY PUBLI~ SUSAN F- LONG Notary Public, State of New Yod; No. 01 L04958343 Qualified in Suffolk County Commission Expires November 6. EXAMINED APPROVED DIS Approved; 2/27/85 617'.21 ~ Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Or~ly SEQR PART I--PROJECT INFORMATION (To be completed by Applicant or Project sDbnsor'~ 4. PRECfS~ LOCA~ON {S~e~ address a~road inters~t~s, prominent landmarks, etc.. or Provide map) ~ Expansion ~ M~ificatlon/alteratio, 6. DESCRIBE PR~ECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: acres Ultimately (~ acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTR[CTIONS? ~Yes [] NO If No. describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ~Reslden Ilar [] !ndustrial ~ Commermal [] Agricu~t ute [] ParklForestlODen space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING~ NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY fFEDERAL. STATE OR LOCAL)? .~ Yes [] No If yes. list agency(s) and r~ermit/aDprovam DF--C, -Fowr~ oF 11o DOES ANY ASPECT OF THE AOflON HAVE A CURRENTLY VAMD PERMIT OR APPROVAL? Z ~ Yes ~o If yes, li~t agency name and permlt/aporoval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] YeS ;E3No ! CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II--ENVIRONMENTAL ASSESSMENT fTo be comDleted by Agency) A. DOES ACTfON EXCEED ANY TYPE ~ESHOLD IN 6 NYCRR PART 617.127 If yes, co~ ~te the rewew process ~nd use the FULL ~F1 B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN S NYCRP,, PART 617.67 If NO. a negative declaration may be superseded by another involved agency. [] Yes [] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: ~Answers may oe handwritten if legibtel C1. Existing air quality, ~urface or groundwater quality or auantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C4. A community's existing plans or goats as officially adopted, or a change tn use or Intensity of use al land or other natural resources? E×Dlaln briefly Growth. subsequent develooment, or reiated acUvities likely to be induced by the proposed action? Explain briefly, C6. Long term. short term. cumulative, or other effects not ~entified in C1-C57 Explain briefly. C7. Other imoacts linci[~ding changes in use of either quantity or type of energyl? Explain briefly, THERE. OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? [] Yes [] No If Yes, explain briefly PART III--DETERMINATION OF SIGNIFICANCE CI-o be completed by Agency) INSTRUCTIONS: For each adverse effect identffied above, determine whether it Is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its la) setting (i.e. urban or rural); lb) probability of occurring; lc) duration; (d) ,irreversibillty; {e) gebgraphic scope; ~nd (f) m~.gnitude. If nec~ssa;7, add attachments or reference supporting materials. Ensure that explanations ~ontaln sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. [] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. The~l proceed directly to the FULL FAF and/or prepare a positive declaration. [] Check this box if you have determined, based On the information and analysis above and any supporting documentation, that the proposed action WILt. NOT result in any significant adverse environmental impacts AND provide on ~ttachmeatS as necessary, the reasons supporting this determination: 2 Costelto Marine Contracting Corp. !~.0. BOX 2124 Gr~ei~ ~ 11944-0976 Coste~o ~arlne COntracting Corp. P.O, Box 2t24 Greenl30~. NY 11944-0976 AUII~RIZATIOfl LEII£H , do hereby give Costello Iqi~'tflii i:ittiti~aCt, titg Corp. Ihe authority t.o act as agent In mY behalf !. applying ill i ocatiI f permits til order for work to be done on my property described -- Signature Memo SUE LONG COSTELLO MA. RI~~P. ~ p.O. Box 2124 Greenport, NY 11944 (5i6) 477-1199